Why Being Fat Is Not Always Obvious

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Nearly 2/3 of parents underestimate their children’s weight, and half of parents do not recognize that their children are overweight or obese, reports a new study published in the journal Pediatrics.

For the study, “Parental Underestimates of Child Weight: A Meta-analysis,” a team of researchers reviewed 121 published studies containing more than 80,000 estimates of a child’s weight by his or her parent. The researchers concluded that “half of parents underestimated their children’s overweight/obese status and a significant minority underestimated children’s normal weight.”

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The results are surprising to many people, given the widespread concern over children’s health and high-profile measures — by Michelle Obama and others — to start healthy behaviors early.

The idea that many people don’t notice overweight children in our famously fat-phobic society seems absurd. After all, aren’t all Americans constantly judging themselves and others over every unwanted ounce?

Actually, no. Two-thirds of American adults are overweight, and more women than men are obese, yet fewer than 1/4 are dieting at any given time. Only a minority of Americans eat a healthy diet, and fewer than 1/3 get regular exercise.

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Invisible Obesity

The study is very much in line with previous research showing that parents often underestimate their children’s weight, and many people underestimate their own weight.

A 2010 study published in the journal “Obstetrics & Gynecology” found that nearly 40 percent of overweight women and 10.5 percent of obese women believed themselves to be underweight or of normal weight. Surprisingly, though it’s often claimed that most women think they are too fat, only 16 percent of normal-weight women in the study perceived themselves as overweight.

There are several possible reasons why being overweight is not obvious to many people, including depictions of overweight individuals in the media that tend to be extreme (i.e., morbidly obese) instead of overweight, and thus viewers have a skewed idea of what health-damaging obesity looks like.

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For example the contestants on the hit reality television show “The Biggest Loser” are not merely a few pounds overweight — since dropping a few pounds would not make a dramatic success story — but instead may weigh two or three times as much as they should at a healthy weight.

Viewers may compare themselves to the contestants and assume that their own weight — though admittedly a little high but nothing to really worry about — is acceptable because at least they don’t tip the scale at 400 pounds.

Another factor may be a social hypersensitivity to acknowledging that a child is overweight for fear of possibly triggering eating disorders such as anorexia nervosa or bulimia.

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A high-profile example of this concern arose in 2011 when a book titled “Maggie Goes On a Diet” was published. It’s about an overweight teen who chooses to lose weight to feel better about herself, get healthier, and play a sport she loves. The book was widely criticized as dangerous — mostly by those who had not read it — because they assumed that the word “diet” in the title referred to calorie restriction. However it did not. In the book Maggie loses weight in the way that doctors and nutritionists have recommended for decades: making healthy food choices and getting exercise.

The concern than an overweight child should not be encouraged to lose weight for fear of it being taken too far is largely unfounded. Eating disorders such as anorexia nervosa are mental illnesses, caused by several factors including genetics.

Calorie-restrictive dieting can contribute to anorexia in rare cases — about 1 percent of the population who already have a predisposition for the disorder. But the vast majority of people who lose weight as doctors recommend — healthy diet and exercise — benefit greatly and are at little or no risk for eating disorders.

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Similar concerns arose in 2010 when medical research found that obese women are up to 60 percent more likely to develop cancer as compared to healthy-weight women, and that up to a third of breast cancers in Western countries could be avoided if women ate less and exercised more.

As Associated Press reporter Maria Cheng noted, there was a reluctance on the part of many doctors to make too much of the study: “Any discussion of weight and breast cancer is considered sensitive because some may misconstrue that as the medical establishment blaming women for their disease.”

Cheng is referring to an institutionalized “fat taboo,” in which some fear that if women — statistically most of whom are overweight — are (truthfully) told that they can reduce their risk of cancer by slimming down, they will blame themselves if they get cancer.

The issue of not recognizing being overweight or obese is a serious concern for doctors, especially when it relates to children. A parent is responsible for the health of their child, ,and if they don’t recognize that he or she is overweight or obese, that could have dire health consequences because they will not take steps to address the problem.